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Cambia Health Solutions jobs in Salt Lake City, UT - 70 jobs

  • Risk Adjustment Provider Educator

    Cambia Health Solutions 3.9company rating

    Cambia Health Solutions job in Salt Lake City, UT

    Provider Educator Work a Hybrid schedule within Oregon, Washington, Idaho or Utah Build a career with purpose. Join our Cause to create a person-focused and economically sustainable health care system. Who We Are Looking For: Every day, Cambia's dedicated team of Provider Educators is living our mission to make health care easier and lives better. As a member of the Risk Adjustment team, our Provider Educators are responsible for developing communications, content and engaging network providers in support of provider education objectives. - all in service of creating a person-focused health care experience. Do you have a passion for serving others and learning new things? Do you thrive as part of a collaborative, caring team? Then this role may be the perfect fit. What You Bring to Cambia: Qualifications: Provider Education Coordinator would have a Bachelor's degree in a related field and at least 5 years of Medicare Advantage or Commercial risk adjustment experience including at least 4 years of experience in a HCC Coding Audit or Network Management role or equivalent combination of education and experience. CPC and/or CRC credentials preferred Skills and Attributes: Strong consulting, communication (written and verbal), influencing, and facilitation skills Proficiency in using Microsoft Office tools and proven ability to display analytical data and research findings for effective presentations and improved decision making. Knowledge of health care industry trends, provider relations, and risk adjustment HCC coding, ICD10 diagnosis coding. Knowledge of health insurance preferred, including medical and dental terminology, procedural and diagnosis coding, reimbursement methodologies and various provider network arrangements. What You Will Do at Cambia: Develops, coordinates, and drives risk adjustment education initiatives with network providers and acts as primary point of contact for assigned key provider engagements across Commercial and Medicare lines of business Coordinate outreach, communication, training, and education for providers that have been identified through various operational reporting channels as a candidate for provider education engagement Works with key leaders within the provider organization to engage with and drive successful performance of the provider engagement. Assists senior leadership with special projects related to advancing Cambia's value based and innovative provider relationships. Participates in definition of project deliverables, providing consultation, recommendations, and solutions, reviewing project mandates and directives to determine overall provider engagement approach Leads, under the direction of management, in design and implementation of initiative related administrative policies and procedures and provides guidance and direction to the work team Work Environment No unusual working conditions. Work primarily performed in an office environment. Some travel may be required The expected hiring range for a Provider Educator is $83,300.00 - $111,600.00 depending on skills, experience, education, and training; relevant licensure / certifications; performance history; and work location. The bonus target for this position is 10%. The current full salary range for this role is $78,000.00 to $128,000.00. #LI-hybrid About Cambia Working at Cambia means being part of a purpose-driven, award-winning culture built on trust and innovation anchored in our 100+ year history. Our caring and supportive colleagues are some of the best and brightest in the industry, innovating together toward sustainable, person-focused health care. Whether we're helping members, lending a hand to a colleague or volunteering in our communities, our compassion, empathy and team spirit always shine through. Why Join the Cambia Team? At Cambia, you can: Work alongside diverse teams building cutting-edge solutions to transform health care. Earn a competitive salary and enjoy generous benefits while doing work that changes lives. Grow your career with a company committed to helping you succeed. Give back to your community by participating in Cambia-supported outreach programs. Connect with colleagues who share similar interests and backgrounds through our employee resource groups. We believe a career at Cambia is more than just a paycheck - and your compensation should be too. Our compensation package includes competitive base pay as well as a market-leading 401(k) with a significant company match, bonus opportunities and more. In exchange for helping members live healthy lives, we offer benefits that empower you to do the same. Just a few highlights include: Medical, dental and vision coverage for employees and their eligible family members, including mental health benefits. Annual employer contribution to a health savings account. Generous paid time off varying by role and tenure in addition to 10 company-paid holidays. Market-leading retirement plan including a company match on employee 401(k) contributions, with a potential discretionary contribution based on company performance (no vesting period). Up to 12 weeks of paid parental time off (eligibility requires 12 months of continuous service with Cambia immediately preceding leave). Award-winning wellness programs that reward you for participation. Employee Assistance Fund for those in need. Commute and parking benefits. Learn more about our benefits. We are happy to offer work from home options for most of our roles. To take advantage of this flexible option, we require employees to have a wired internet connection that is not satellite or cellular and internet service with a minimum upload speed of 5Mb and a minimum download speed of 10 Mb. We are an Equal Opportunity employer dedicated to a drug and tobacco-free workplace. All qualified applicants will receive consideration for employment without regard to race, color, national origin, religion, age, sex, sexual orientation, gender identity, disability, protected veteran status or any other status protected by law. A background check is required. If you need accommodation for any part of the application process because of a medical condition or disability, please email ******************************. Information about how Cambia Health Solutions collects, uses, and discloses information is available in our Privacy Policy.
    $83.3k-111.6k yearly Auto-Apply 36d ago
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  • Stop Loss Producer Relations Administrator II

    Cambia Health 3.9company rating

    Cambia Health job in Salt Lake City, UT

    Work a remote schedule Build a career with purpose. Join our Cause to create a person-focused and economically sustainable health care system. Who We Are Looking For: Every day, Cambia's dedicated team of Stop Loss Producer Relations Administrator II is living our mission to make health care easier and lives better. As a member of the Stop Loss team, we are Responsible for all producer relations activities which includes responding to agent questions and optimizing the agent experience with Cambia - all in service of creating a person-focused health care experience. Do you have a passion for serving others and learning new things? Do you thrive as part of a collaborative, caring team? Then this role may be the perfect fit. What You Bring to Cambia: Qualifications: Producer Relations Administrator II would have a Bachelor's Degree in business or related field preferred and 7 years of experience in healthcare administration, sales or project management or equivalent combination of education and experience. Required Licenses, Certifications, Registration, Etc. * Producer Disability & Life license is preferred. Skills and Attributes: * Ability to effectively interpret policies and procedures and communicate complex topics and related content to internal and external customers. * Strong organizational and time management skills with the ability to manage workload independently. * Ability to think critically and make decisions within individual role and responsibility. * General computer skills including use of Microsoft Office products and Customer Relationship Management (CRM) software. Familiarity with health care documentation systems. * Strong verbal, written and interpersonal communication and customer service skills. * Demonstrated ability to coordinate multiple projects simultaneously with a high level of accuracy. * Knowledge of corporate and state policy regarding appointment of insurance producers, preferred. * Progressive experience in producer relations activities * Ability to effectively interpret complex policies and procedures and effectively communicate these complicated topics and content to internal and external customers. * Ability to conduct producer relations activities for two or more states. * State Producer license for in the state(s) where producer relations activities are supported, is preferred * Ability to understand, reconcile, track and monitor complex systems. * Experience with AI tools and technologies to enhance productivity and decision-making in professional settings highly desired * Experience with AI tools and technologies to enhance productivity and decision-making in professional settings highly desired What You Will Do at Cambia: * Accountable for agent appointment requirements, contracting and appointment intake, maintenance of producer files, and processing online producer portal applications. * Verification of producer information for internal and external customers. Provides timely information to our agents, producers and brokers on programs, requirements and agent educational opportunities. * Verifies producer appointments for the payment/bonus process to ensure producer eligibility for payment. * Researches, documents and communicates to producers for resolution of payment issues and producer appointment issues. Researches and responds to commissions related issues and coordinates commission payments with Sales. * Accountable for processing and coordinating all producer changes, licensing and renewals. Monitors and reports employee producer licensing to sales management. Notifies sales staff of new producer appointments. * Contributes and reviews content for internal and external producer related communications for Cambia wide distribution. * Represent the sales department on project teams, coordinate special meetings and perform research and analysis to contribute to the overall success of sales and sales operations department objectives. * Audits and processes appointment requests, state appointment forms, and producer contract materials, including producer licenses and proof of Errors and Omissions insurance. * Works with the State Department of Insurance on audits of producer information and compliance with State regulatory requirements. Complies with regulatory requirements and security efforts as related to position. * Maintain policies and desk procedures as necessary partnering with downstream departments to consistently drive efficiency and optimal service levels. * Assist producers with licensing within Producer Center and resolves system issues. * Plans, organizes and prioritizes assignments to comply with performance standards, corporate goals, and established timelines. * Identifies problems or needed changes, recommends resolution, and participates in quality improvement efforts. * Assists in Cambia sponsored producer activities and forums * Provide training, coaching, development, and guidance to team members. * Assists in project development and implementation including development of training materials and presentations. Work Environment * No unusual working conditions. * Work primarily performed in an office environment. The expected hiring range for a Producer Rel Admin II is $68,850.00 - $93,150.00 depending on skills, experience, education, and training; relevant licensure / certifications; performance history; and work location. The bonus target for this position is 10%. The current full salary range for this role is $65,000.00 to $107,000.00. #LI-Remote About Cambia Working at Cambia means being part of a purpose-driven, award-winning culture built on trust and innovation anchored in our 100+ year history. Our caring and supportive colleagues are some of the best and brightest in the industry, innovating together toward sustainable, person-focused health care. Whether we're helping members, lending a hand to a colleague or volunteering in our communities, our compassion, empathy and team spirit always shine through. Why Join the Cambia Team? At Cambia, you can: * Work alongside diverse teams building cutting-edge solutions to transform health care. * Earn a competitive salary and enjoy generous benefits while doing work that changes lives. * Grow your career with a company committed to helping you succeed. * Give back to your community by participating in Cambia-supported outreach programs. * Connect with colleagues who share similar interests and backgrounds through our employee resource groups. We believe a career at Cambia is more than just a paycheck - and your compensation should be too. Our compensation package includes competitive base pay as well as a market-leading 401(k) with a significant company match, bonus opportunities and more. In exchange for helping members live healthy lives, we offer benefits that empower you to do the same. Just a few highlights include: * Medical, dental and vision coverage for employees and their eligible family members, including mental health benefits. * Annual employer contribution to a health savings account. * Generous paid time off varying by role and tenure in addition to 10 company-paid holidays. * Market-leading retirement plan including a company match on employee 401(k) contributions, with a potential discretionary contribution based on company performance (no vesting period). * Up to 12 weeks of paid parental time off (eligibility requires 12 months of continuous service with Cambia immediately preceding leave). * Award-winning wellness programs that reward you for participation. * Employee Assistance Fund for those in need. * Commute and parking benefits. Learn more about our benefits. We are happy to offer work from home options for most of our roles. To take advantage of this flexible option, we require employees to have a wired internet connection that is not satellite or cellular and internet service with a minimum upload speed of 5Mb and a minimum download speed of 10 Mb. We are an Equal Opportunity employer dedicated to a drug and tobacco-free workplace. All qualified applicants will receive consideration for employment without regard to race, color, national origin, religion, age, sex, sexual orientation, gender identity, disability, protected veteran status or any other status protected by law. A background check is required. If you need accommodation for any part of the application process because of a medical condition or disability, please email ******************************. Information about how Cambia Health Solutions collects, uses, and discloses information is available in our Privacy Policy.
    $68.9k-93.2k yearly Auto-Apply 8d ago
  • Sales Support, Clinical Specialist - Heart Rhythm Management - Image Guided Therapy (Salt Lake City & Denver)

    Philips Healthcare 4.7company rating

    Salt Lake City, UT job

    Job TitleSales Support, Clinical Specialist - Heart Rhythm Management - Image Guided Therapy (Salt Lake City & Denver) Job Description As a Clinical Specialist with our Lead Management team you will provide clinical expertise and organic revenue generation and growth to drive customer engagement and accelerate the sales process. You will assist in developing a highly knowledgeable customer base, drive and sustain Health Care Provider Education efforts, and help drive full product portfolio utilization to meet the needs of our customers. Your role: Conducting formal product/sales presentations to all clinical decision makers and physicians within the hospital, practice, and/or clinical setting. Coordinating with other members of the IGTS (Systems) and IGTD (Devices) Philips teams to deliver customized solutions for our customers. Prospecting for new customers and growing and maintaining target revenue volume in assigned accounts along with Territory Managers (TMs) and Regional Sales Managers (RSMs). Growing awareness of the clinical application of Philips IGTD products by recruiting physicians and staff to attend training programs and in-services. Supporting the evaluation of new products and providing clinical feedback to marketing and sales. Keeping tabs on competitive products, current and future IGTD products, and relevant clinical publications and updates. Consistently working to improve clinical and sales acumen, competitive product knowledge, and customer relationship/sales skills. You're the right fit if: You've acquired 5+ years of experience in clinical sales, preferred Your skills include strong clinical and technical knowledge with the confidence to knowledgeably engage key stakeholders to present a value proposition, excellent planning and organizational, project management and time management skills, and professional presence that influences desired results with both external and internal partners. You must be able to successfully perform the following minimum Physical, Cognitive and Environmental job requirements with or without accommodation for this Sales position. You have a bachelor's degree or equivalent experience How we work together We believe that we are better together than apart. For our office-based teams, this means working in-person at least 3 days per week. Onsite roles require full-time presence in the company's facilities. Field roles are most effectively done outside of the company's main facilities, generally at the customers' or suppliers' locations. This role is a field role. About Philips We are a health technology company. We built our entire company around the belief that every human matters, and we won't stop until everybody everywhere has access to the quality healthcare that we all deserve. Do the work of your life to help improve the lives of others. Learn more about our business. Discover our rich and exciting history. Learn more about our purpose. Learn more about our culture. Philips Transparency Details Total Target Earnings is composed of base salary + target incentive. At 85% to 120% performance achievement, the Target Earning potential is $110,500 - $192,000 annually, plus company fleet/car. Total compensation may be higher or lower dependent upon individual performance. Target Earnings pay is only one component of the Philips Total Rewards compensation package, which includes a generous PTO, 401k (up to 7% match), HSA (with company contribution), stock purchase plan, education reimbursement and much more. Details about our benefits can be found here. Additional Information US work authorization is a precondition of employment. The company will not consider candidates who require sponsorship for a work-authorized visa, now or in the future. Company relocation benefits will not be provided for this position. For this position, you must reside in or within commuting distance to Salt Lake City #LI-PH1 #LI-FIELD This requisition is expected to stay active for 45 days but may close earlier if a successful candidate is selected or business necessity dictates. Interested candidates are encouraged to apply as soon as possible to ensure consideration. Philips is an Equal Employment and Opportunity Employer including Disability/Vets and maintains a drug-free workplace.
    $59k-76k yearly est. Auto-Apply 60d+ ago
  • National Support Specialist, Multivendor Services - Siemens

    Philips Healthcare 4.7company rating

    Salt Lake City, UT job

    Job TitleNational Support Specialist, Multivendor Services - SiemensJob Description Lead and mentor Field Service Engineers, resolve complex escalations quickly, and drive improvements in service quality and parts usage. If you're a technical expert who loves solving problems and elevating team performance, this role puts you at the center of high‑impact service excellence. Your role: Provide leadership, training, and technical expertise to Field Service Engineers (FSEs), supporting them both onsite and remotely to ensure proper troubleshooting and repair methodology. Coach and mentor FSEs to deliver excellent customer experiences, including conducting crucial conversations and supporting technical and process updates through trip reports and seminars. Manage all technical escalations within the region, leading resolution strategies, instructing teams on repair solutions, and ensuring timely, effective corrective actions. Support business improvement efforts through parts review and approval processes, proactive monitoring of high‑activity sites, and leading initiatives to reduce material usage and improve performance. Ensure accountability and adherence to procedures across all repair activities, verifying proper parts usage and maintaining speed and quality of escalation resolution. You're the right fit if: You've acquired 5+ years of experience servicing the following equipment: Luminos Lotus MAX XR, LUMINOS dRF MAX, Siemens Ysio X.PREE XR, MULTIX IMPACT C Digital, Multix Fusion MAX XR, Multix IMPACT DR, LUMINOS dRF, Axiom Luminos Agile, Axiom Luminos Agile Max, Multix Fusion Digital, Mobilett Elara Max, Mobilett Mira Max, Mobilett Mira, Multitom Rax Your skills include the ability to resolve problems remotely utilizing excellent written and verbal communication skills. You have at least a high school diploma. How we work together We believe that we are better together than apart. For our office-based teams, this means working in-person at least 3 days per week. Onsite roles require full-time presence in the company's facilities. Field roles are most effectively done outside of the company's main facilities, generally at the customers' or suppliers' locations. This is a field role. About Philips We are a health technology company. We built our entire company around the belief that every human matters, and we won't stop until everybody everywhere has access to the quality healthcare that we all deserve. Do the work of your life to help improve the lives of others. Learn more about our business. Discover our rich and exciting history. Learn more about our purpose. Learn more about our culture. Philips Transparency Details The pay range for this position in Utah, Arizona is $39.05 to $62.48 per hour. The pay range for this position in Nevada, Colorado is $41.11 to $65.77 per hour. The pay range for this position in Washington is $43.16 to $69.06 per hour. The pay range for this position in California is $46.04 to $73.66 per hour. The actual base pay offered may vary within the posted ranges depending on multiple factors including job-related knowledge/skills, experience, business needs, geographical location, and internal equity. In addition, other compensation, such as an annual incentive bonus, sales commission or long-term incentives may be offered. Employees are eligible to participate in our comprehensive Philips Total Rewards benefits program, which includes a generous PTO, 401k (up to 7% match), HSA (with company contribution), stock purchase plan, education reimbursement and much more. Details about our benefits can be found here. At Philips, it is not typical for an individual to be hired at or near the top end of the range for their role and compensation decisions are dependent upon the facts and circumstances of each case. Additional Information US work authorization is a precondition of employment. The company will not consider candidates who require sponsorship for a work-authorized visa, now or in the future. Company relocation benefits will not be provided for this position. For this position, you must reside in or within commuting distance to the zone. #LI-PH1 This requisition is expected to stay active for 45 days but may close earlier if a successful candidate is selected or business necessity dictates. Interested candidates are encouraged to apply as soon as possible to ensure consideration. Philips is an Equal Employment and Opportunity Employer including Disability/Vets and maintains a drug-free workplace.
    $40k-56k yearly est. Auto-Apply 9d ago
  • Inpatient Medical Coding Auditor

    Humana 4.8company rating

    Salt Lake City, UT job

    **Become a part of our caring community and help us put health first** The Inpatient Medical Coding Auditor reviews a variety of medical records and to determine appropriate procedural terminology and medical codes (e.g., ICD-10-CM, CPT.) The Inpatient Medical Coding Auditor work assignments involve moderately complex to complex issues where the analysis of situations or data requires an in-depth evaluation of variable factors. The Inpatient Medical Coding Auditor confirms appropriate diagnosis related group (DRG) assignments upon appeal. Analyzes, enters and manipulates database. Responds to or clarifies internal requests for medical information. Begins to influence department's strategy. Makes decisions on moderately complex to complex issues regarding technical approach for project components, and work is performed without direction. Exercises considerable latitude in determining objectives and approaches to assignments. **Use your skills to make an impact** **WORK STYLE:** Remote, work at home. While this is a remote position, occasional travel to Humana's offices for training or meetings may be required. **WORK HOURS:** Typical business hours are Monday-Friday, 8 hours/day, 5 days/week-- some flexibility might be possible, once training is complete and depending on business needs. Associates are expected to start each workday between 6AM-9AM EST, regardless of their home time zone. **Required Qualifications** + RHIA, RHIT, or CCS Certification + At least 2 years' experience in acute in-patient coding experience and/or MS-DRG auditing + Recent experience auditing using CMS Manual, LCD, NCD, and Coding Guidelines + Experience reading and interpreting claims + Excellent written and verbal communication skills + Working knowledge of Microsoft Office Programs Word, PowerPoint, and Excel + Strong attention to detail + Can work independently and determine appropriate course of action + Must be passionate about contributing to an organization focused on continuously improving consumer experiences **Preferred Qualifications** + Associate's Degree or higher in Health Information Management (HIM) + Experience in Financial Recovery + Experience in a fast paced, metric driven operational setting + Experience in APR DRG coding/auditing **Additional Information** **Work at Home Requirements** - At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is recommended; wireless, wired cable or DSL connection is suggested - Satellite, cellular and microwave connection can be used only if approved by leadership - Associates who live and work from Home in the state of California, Illinois, Montana, or South Dakota will be provided a bi-weekly payment for their internet expense. - Humana will provide Home or Hybrid Home/Office associates with telephone equipment appropriate to meet the business requirements for their position/job. - Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information **Interview Format** As part of our hiring process for this opportunity, we will be using an exciting interviewing technology called Hire Vue (formerly Modern Hire) to enhance our hiring and decision-making ability. Hire Vue (formerly Modern Hire allows us to quickly connect and gain valuable information from you pertaining to your relevant skills and experience at a time that is best for your schedule. If you are selected to move forward from your application prescreen, you will receive correspondence inviting you to participate in a pre-recorded Voice Interview and/or an SMS Text Messaging interview. If participating in a pre-recorded interview, you will respond to a set of interview questions via your phone. You should anticipate this interview to take approximately 10-15 minutes. If participating in a SMS Text interview, you will be asked a series of questions to which you will be using your cell phone or computer to answer the questions provided. Expect this type of interview to last anywhere from 5-10 minutes. Your recorded interview(s) via text and/or pre-recorded voice will be reviewed and you will subsequently be informed if you will be moving forward to next round of interviews. Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required. **Scheduled Weekly Hours** 40 **Pay Range** The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc. $71,100 - $97,800 per year This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance. **Description of Benefits** Humana, Inc. and its affiliated subsidiaries (collectively, "Humana") offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities. Application Deadline: 01-22-2026 **About us** Humana Inc. (NYSE: HUM) is committed to putting health first - for our teammates, our customers and our company. Through our Humana insurance services and CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health - delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare, Medicaid, families, individuals, military service personnel, and communities at large. **Equal Opportunity Employer** It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment. Humana complies with all applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, sex, sexual orientation, gender identity or religion. We also provide free language interpreter services. See our ***************************************************************************
    $71.1k-97.8k yearly 16d ago
  • Medical Director Medicaid

    Humana 4.8company rating

    Salt Lake City, UT job

    **Become a part of our caring community and help us put health first** The Medical Director relies on medical background and reviews health claims. The Medical Director work assignments involve moderately complex to complex issues where the analysis of situations or data requires an in-depth evaluation of variable factors. The Medical Director actively uses their medical background, experience, and judgement to make determinations whether requested services, requested level of care, and/or requested site of service should be authorized. All work occurs with a context of regulatory compliance, and work is assisted by diverse resources which may include national clinical guidelines, CMS policies and determinations, clinical reference materials, internal teaching conferences, and other sources of expertise. Medical Directors will learn Medicare and Medicare Advantage requirements, and will understand how to operationalize this knowledge in their daily work. The Medical Director's work includes computer based review of moderately complex to complex clinical scenarios, review of all submitted clinical records, prioritization of daily work, communication of decisions to internal associates, and possible participation in care management. The clinical scenarios predominantly arise from inpatient or post-acute care environments. Has discussions with external physicians by phone to gather additional clinical information or discuss determinations regularly, and in some instances these may require conflict resolution skills. Some roles include an overview of coding practices and clinical documentation, grievance and appeals processes, and outpatient services and equipment, within their scope. The Medical Director may speak with contracted external physicians, physician groups, facilities, or community groups to support regional market priorities, which may include an understanding of Humana processes, as well as a focus on collaborative business relationships, value based care, population health, or disease or care management. Medical Directors support Humana values, and Humana's Bold Goal mission, throughout all activites. **Use your skills to make an impact** **Responsibilities** The Medical Director provides medical interpretation and determinations whether services provided by other healthcare professionals are in agreement with national guidelines, CMS requirements, Humana policies, clinical standards, and (in some cases) contracts. The ideal candidate supports and collaborates with other team members, other departments, Humana colleagues and the Regional VP Health Services. After completion of mentored training, daily work is performed with minimal direction. Enjoys working in a structured environment with expectations for consistency in thinking and authorship. Exercises independence in meeting departmental expectations, and meets compliance timelines. Supports the assigned work with respect to market-wide objectives (e.g. Bold Goal) and community relations as directed. **Required Qualifications** + MD or DO degree + 5+ years of direct clinical patient care experience post residency or fellowship, which preferably includes some experience in an inpatient environment and/or related to care of a Medicare type population (disabled or >65 years of age). + Current and ongoing Board Certification an approved ABMS Medical Specialty + A current and unrestricted license in at least one jurisdiction and willing to obtain additional license, if required. + No current sanction from Federal or State Governmental organizations, and able to pass credentialing requirements. + Excellent verbal and written communication skills . + Evidence of analytic and interpretation skills, with prior experience participating in teams focusing on quality management, utilization management, case management, discharge planning and/or home health or post acute services such as inpatient rehabilitation. **Preferred Qualifications** + Knowledge of the managed care industry including Medicare Advantage, Managed Medicaid and/or Commercial products, or other Medical management organizations, hospitals/ Integrated Delivery Systems, health insurance, other healthcare providers, clinical group practice management. + Utilization management experience in a medical management review organization, such as Medicare Advantage, managed Medicaid, or Commercial health insurance. + Experience with national guidelines such as MCG or InterQual + Internal Medicine, Family Practice, Geriatrics, Hospitalist, Emergency Medicine clinical specialists + Advanced degree such as an MBA, MHA, MPH + Exposure to Public Health, Population Health, analytics, and use of business metrics. + Experience working with Case managers or Care managers on complex case management, including familiarity with social determinants of health. + The curiosity to learn, the flexibility to adapt and the courage to innovate **Additional Information** Typically reports to a Regional Vice President of Health Services, Lead, or Corporate Medical Director, depending on size of region or line of business. The Medical Director conducts Utilization Management of the care received by members in an assigned market, member population, or condition type. May also engage in grievance and appeals reviews. May participate on project teams or organizational committees. \#physiciancareers Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required. **Scheduled Weekly Hours** 40 **Pay Range** The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc. $223,800 - $313,100 per year This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance. **Description of Benefits** Humana, Inc. and its affiliated subsidiaries (collectively, "Humana") offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities. Application Deadline: 04-15-2026 **About us** Humana Inc. (NYSE: HUM) is committed to putting health first - for our teammates, our customers and our company. Through our Humana insurance services and CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health - delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare, Medicaid, families, individuals, military service personnel, and communities at large. **Equal Opportunity Employer** It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment. Humana complies with all applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, sex, sexual orientation, gender identity or religion. We also provide free language interpreter services. See our ***************************************************************************
    $223.8k-313.1k yearly 6d ago
  • Pharmacy Care Coordinator

    Unitedhealth Group Inc. 4.6company rating

    Murray, UT job

    Opportunities with Genoa Healthcare. A career with Genoa Healthcare means you're part of a collaborative effort to serve behavioral health and addiction treatment communities. We do more than just provide medicine: we change lives for the better. People with serious mental or chronic illness - and those who care for them - have moving stories, and at Genoa we become their voice, their partner. Working as part of a coordinated care team, we partner with community-based providers and others to ensure that people with complex health conditions get the right medications and are able to follow their treatment plans. Our personalized services - in-clinic pharmacies, medication management and more - are leading the way to a new level of care. Genoa is a pharmacy care services company that is part of Optum and UnitedHealth Group's family of businesses. We are part of a leading information and technology-enabled health services business dedicated to making the health system work better for everyone. Join us to start Caring. Connecting. Growing together. The Patient Care Coordinator position at Genoa is an essential role that impacts the lives of an underserved population that needs a voice. This position is a liaison between a partner clinic and a Genoa mental health specialty pharmacy. Primary responsibilities include building strong relationships with the clinic partners and communicating with consumers to assist them with their medication plan, insurance and the full services of the Genoa pharmacy. A key function will be promoting Genoa services to obtain new consumers and increasing the number of consumers Genoa serves. Hours: Monday-Friday 8:30am to 5:30pm MST Location: 4 days at 3802 S 700 E, Salt Lake City, UT, 84106 and 1 day at 154 East Myrtle Ave, Ste 101, Murray, UT, 84107; manager will let you know which days will be at which site Primary Responsibilities: * Communicates with all consumers of the mental health center regarding the medication services Genoa provides * Recruits and enrolls consumers utilizing enrollment forms and copy the consumer's insurance card * Facilitates the collection of prescriptions to be faxed to the pharmacy for dispensing * Ensures all consumer insurance information is up to date in the Pharmacy system and is properly charged for the medications dispensed * Assists consumers in contacting the pharmacist regarding all their medication questions and ensure a prompt response to their questions * Assists clinic staff and pharmacy with prior authorizations and Patient Assistance programs as needed * Monitors compliance by contacting the consumer at least monthly to ensure compliance and determine refill needs as applicable * Prescription refill management by utilizing the no refill report and contacting the appropriate prescriber to ensure timely refills are completed and dispensed to the consumer * Medication delivery when needed and appropriate. {Only applicable in states that are allowed.} * Checks for expiration dates (both on consumer's medications as well as house account products/standing order meds) * Ensures that medications are stored properly (refrigerated drugs are kept in the refrigerator, pen-tips are not stored on insulin pens, etc.) * Checks for discrepancies (dose changes, discontinued medications, etc.) What are the reasons to consider working for UnitedHealth Group? Put it all together - competitive base pay, a full and comprehensive benefit program, performance rewards, and a management team who demonstrates their commitment to your success. Some of our offerings include: * Paid Time Off which you start to accrue with your first pay period plus 8 Paid Holidays * Medical Plan options along with participation in a Health Spending Account or a Health Saving account * Dental, Vision, Life& AD&D Insurance along with Short-term disability and Long-Term Disability coverage * 401(k) Savings Plan, Employee Stock Purchase Plan * Education Reimbursement * Employee Discounts * Employee Assistance Program * Employee Referral Bonus Program * Voluntary Benefits (pet insurance, legal insurance, LTC Insurance, etc.) * More information can be downloaded at: ************************* You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in. Required Qualifications: * Active and unrestricted Pharmacy Technician license in the state of Utah * Access to reliable transportation & valid US driver's license Preferred Qualification: * National Pharmacy Technician Certification Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The hourly pay for this role will range from $17.74 to $31.63 per hour based on full-time employment. We comply with all minimum wage laws as applicable. At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location, and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups, and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission. UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations. UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment. #RPO #RED
    $17.7-31.6 hourly 29d ago
  • Financial Analytics Professional

    Humana 4.8company rating

    Salt Lake City, UT job

    **Become a part of our caring community and help us put health first** The Financial Analytics Professional 2 manages data to support and influence decisions on day-to-day operations, strategic planning and specific business performance issues. The Financial Analytics Professional 2 work assignments are varied and frequently require interpretation and independent determination of the appropriate courses of action. The Financial Analytics Professional 2 collates, models, interprets and analyzes data in order to identify, explain, influence variances and trends. Explains variances and trends and enhances modeling techniques. May possess financial or actuarial background. Understands department, segment, and organizational strategy and operating objectives, including their linkages to related areas. Makes decisions regarding own work methods, occasionally in ambiguous situations, and requires minimal direction and receives guidance where needed. Follows established guidelines/procedures. **Use your skills to make an impact** **Required Qualifications** + Bachelor's Degree + 5 years technical experience + Experience in compiling, modeling, interpreting and analyzing data in order to identify, explain, influence variances and trends + Explain variances and trends and enhance modeling techniques + Experience in managing data to support and influence decisions on day-to-day operations, strategic planning and specific business performance issues + Possess a working knowledge and understand department, segment and organizational strategy + Must be passionate about contributing to an organization focused on continuously improving consumer experiences **Preferred Qualifications** + Master's Degree + Financial or Actuarial background + Project Management Certification **Additional Information** This role will be primarily responsible for preparing data and summarization for industry-wide Medicaid actuarial analyses. Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required. **Scheduled Weekly Hours** 40 **Pay Range** The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc. $66,800 - $91,100 per year This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance. **Description of Benefits** Humana, Inc. and its affiliated subsidiaries (collectively, "Humana") offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities. Application Deadline: 01-30-2026 **About us** Humana Inc. (NYSE: HUM) is committed to putting health first - for our teammates, our customers and our company. Through our Humana insurance services and CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health - delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare, Medicaid, families, individuals, military service personnel, and communities at large. **Equal Opportunity Employer** It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment. Humana complies with all applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, sex, sexual orientation, gender identity or religion. We also provide free language interpreter services. See our ***************************************************************************
    $25k-37k yearly est. 14d ago
  • Humana Pharmacy Solutions Process Improvement Professional 2

    Humana 4.8company rating

    Salt Lake City, UT job

    **Become a part of our caring community and help us put health first** The Process Improvement Professional 2 analyzes, and measures the effectiveness of existing business processes and develops sustainable, repeatable and quantifiable business process improvements. The Process Improvement Professional 2 work assignments are varied and frequently require interpretation and independent determination of the appropriate courses of action. The Process Improvement Professional 2 researches best business practices within and outside the organization to establish benchmark data. Collects and analyzes process data to initiate, develop and recommend business practices and procedures that focus on enhanced safety, increased productivity and reduced cost. Determines how new information technologies can support re-engineering business processes. May specialize in one or more of the following areas: benchmarking, business process analysis and re-engineering, change management and measurement, and/or process-driven systems requirements. Understands department, segment, and organizational strategy and operating objectives, including their linkages to related areas. Makes decisions regarding own work methods, occasionally in ambiguous situations, and requires minimal direction and receives guidance where needed. Follows established guidelines/procedures. The Process Improvement Professional 2 position is essential for preparing those cases for review by the clinician. This role is responsible for critical tasks such as case preparation, data validation, provider outreach, and documentation, which collectively ensure compliance and operational continuity. Additionally, this role works to procure medical records, an integral part of our case review preparation. **Use your skills to make an impact** **Required Qualifications** + Bachelor's degree + Less than 5 years of technical experience + Must be passionate about contributing to an organization focused on continuously improving consumer experiences **Preferred Qualifications** + >2 years of experience with HCPR processes and/or authorization processes Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required. **Scheduled Weekly Hours** 40 **Pay Range** The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc. $65,000 - $88,600 per year This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance. **Description of Benefits** Humana, Inc. and its affiliated subsidiaries (collectively, "Humana") offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities. Application Deadline: 01-23-2026 **About us** Humana Inc. (NYSE: HUM) is committed to putting health first - for our teammates, our customers and our company. Through our Humana insurance services and CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health - delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare, Medicaid, families, individuals, military service personnel, and communities at large. **Equal Opportunity Employer** It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment. Humana complies with all applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, sex, sexual orientation, gender identity or religion. We also provide free language interpreter services. See our ***************************************************************************
    $65k-88.6k yearly 2d ago
  • AI Scientist I (Healthcare)

    Cambia Health 3.9company rating

    Cambia Health job in Salt Lake City, UT

    Hybrid (Office 3 days/wk - Onsite-Flex) within Oregon, Washington, Idaho or Utah Build a career with purpose. Join our Cause to create a person-focused and economically sustainable health care system. Who We Are Looking For: Every day, Cambia's Applied AI Team is living our mission to make health care easier and lives better. AI Scientists work with various stakeholders to design, develop, and implement data-driven solutions. This position applies expertise in advanced analytical tools such as generative AI, machine learning, deep learning, optimization, and statistical modeling to solve business problems in the healthcare payer domain. AI Scientists work may focus on a particular area of the business such as clinical care delivery, customer experience, or payment integrity, or they may work across several areas spanning the organization. In addition to expertise in generative AI, machine learning, deep learning and analytics this role requires knowledge of data systems, basic software development best practices, and algorithm design. AI Scientists work closely with AI team members in the Product and Engineering tracks to collaboratively develop and deliver models and data-driven products. AI Scientists also collaborate and communicate with business partners to design and develop data-driven solutions to business problems and interpret and communicate results to technical and non-technical audiences - all in service of making our members' health journeys easier. If you're a motivated and experienced AI Scientist looking to make a difference in the healthcare industry, apply for this exciting opportunity today! What You Bring to Cambia: Qualifications and Certifications: * Bachelor's degree (masters or PhD preferred) in a strongly quantitative field such as Computer Science, Statistics, Applied Mathematics, Physics, Operations Research, Bioinformatics, or Econometrics * 0-3 years of related work experience * Equivalent combination of education and experience Skills and Attributes (Not limited to): For all levels: * Demonstrated knowledge of generative AI, machine learning and data science. * Ability to use well-understood techniques and existing patterns to build, analyze, deploy, and maintain models. * Effective in time and task management. * Able to develop productive working relationships with colleagues and business partners. * Strong interest in the healthcare industry. Core Knowledge: * Generative AI:Understanding of foundation models, transformer architectures, and techniques for working with large language models (LLMs). Experience with prompt engineering, fine-tuning approaches, and evaluation methods for generative models. * Machine Learning:Strong mathematical foundation and theoretical grasp of the concepts underlying machine learning, optimization, etc. (see below). Demonstrated understanding of how to structure simple machine learning pipelines (e.g, has prepared datasets, trained and tested models end-to-end). * Data:Strong foundation in data analysis. * Programming:Strong python programming skills. Familiarity with standard data science packages. Familiarity with standard software development best practices. Strong SQL skills a plus. * Algorithms:Understanding of standard algorithms and data structures (ex. search and sort) and their analysis. * Core Knowledge Details and Examples (meant to be representative, not exhaustive; entry level roles are expected to have hands-on experience training and testing AI models, solid mathematical understanding and computer science fundamentals) Generative AI * Large Language Models (LLMs) and their capabilities (e.g, in-context learning, few-shot learning, zero-shot learning) * Prompt engineering techniques and best practices * Fine-tuning approaches (e.g, full fine-tuning, parameter-efficient methods like LoRA, QLoRA) * Retrieval-Augmented Generation (RAG) and knowledge integration * Evaluation methods for generative models (e.g, perplexity, BLEU, ROUGE, human evaluation) * Alignment techniques (e.g, RLHF, constitutional AI, red-teaming) * Multimodal generative models (text-to-image, text-to-video, multimodal understanding) * Responsible AI considerations specific to generative models (e.g, bias, hallucinations, safety) * Familiarity with Gen AI frameworks and tools (e.g, Hugging Face and LangChain) Machine Learning * Classic ML algorithms (e.g, linear and logistic regression, decision and boosted trees, SVM, collaborative filtering, ranking) * Approaches (e.g, supervised, semi-supervised, unsupervised, reinforcement learning, regression, classification, time series modeling, transfer learning) * Foundational ML concepts such as objective functions, regularization and over fitting * Data partitions (train/dev/test) and model development * Hyperparameter tuning and grid search * Evaluation concepts (metrics, feature importance, etc.) * Familiarity with standard python packages (scikit-learn, XGBoost, TensorFlow, PyTorch, etc.) * Familiarity with structure of machine learning pipelines * Deep Learning (basic understanding expected at all levels) * Activation functions * Optimization/Gradient Decent * Common architectures (CNN, RNN, LSTM, GAN, etc.) * Embeddings * Familiarity with specializations (sequence modeling/NLP/computer vision) Math * Linear Algebra * Discrete math * Probability and Statistics * Calculus Data * Research and experiment design * Visualization with data * Answering questions with data What You Will Do at Cambia (Not limited to): Note that these responsibilities are representative but not exhaustive. Higher-level roles involve successively stronger degrees of initiative taking and innovation beyond the core responsibilities listed here. * Researches, designs, develops, and implements data-driven models and algorithms using generative AI, machine learning, deep learning, statistical, and other statistical modeling techniques. * Trains and tests models, and develops algorithms to solve business problems. * Adheres to standard best-practices and establishes principled experimental frameworks for developing data-driven models. * Develops models and performs experiments and analyses that are replicable by others. * Uses open-source packages and managed services when appropriate to facilitate model development * Identifies, measures, analyzes, and visualizes drivers to explain model performance (e.g, feature importance, interpretability, bias and error analysis), both offline (in the development phase) and online (in production). * Uses appropriate metrics and quantified outcomes to drive AI model and algorithm improvements. The expected hiring range for The AI Scientist I is $135k-$145k, depending on skills, experience, education, and training; relevant licensure / certifications; performance history; and work location. The bonus target for this position is 15%. The current full salary range for this position is $104k Low/ $169k MRP About Cambia Working at Cambia means being part of a purpose-driven, award-winning culture built on trust and innovation anchored in our 100+ year history. Our caring and supportive colleagues are some of the best and brightest in the industry, innovating together toward sustainable, person-focused health care. Whether we're helping members, lending a hand to a colleague or volunteering in our communities, our compassion, empathy and team spirit always shine through. Why Join the Cambia Team? At Cambia, you can: * Work alongside diverse teams building cutting-edge solutions to transform health care. * Earn a competitive salary and enjoy generous benefits while doing work that changes lives. * Grow your career with a company committed to helping you succeed. * Give back to your community by participating in Cambia-supported outreach programs. * Connect with colleagues who share similar interests and backgrounds through our employee resource groups. We believe a career at Cambia is more than just a paycheck - and your compensation should be too. Our compensation package includes competitive base pay as well as a market-leading 401(k) with a significant company match, bonus opportunities and more. In exchange for helping members live healthy lives, we offer benefits that empower you to do the same. Just a few highlights include: * Medical, dental and vision coverage for employees and their eligible family members, including mental health benefits. * Annual employer contribution to a health savings account. * Generous paid time off varying by role and tenure in addition to 10 company-paid holidays. * Market-leading retirement plan including a company match on employee 401(k) contributions, with a potential discretionary contribution based on company performance (no vesting period). * Up to 12 weeks of paid parental time off (eligibility requires 12 months of continuous service with Cambia immediately preceding leave). * Award-winning wellness programs that reward you for participation. * Employee Assistance Fund for those in need. * Commute and parking benefits. Learn more about our benefits. We are happy to offer work from home options for most of our roles. To take advantage of this flexible option, we require employees to have a wired internet connection that is not satellite or cellular and internet service with a minimum upload speed of 5Mb and a minimum download speed of 10 Mb. We are an Equal Opportunity employer dedicated to a drug and tobacco-free workplace. All qualified applicants will receive consideration for employment without regard to race, color, national origin, religion, age, sex, sexual orientation, gender identity, disability, protected veteran status or any other status protected by law. A background check is required. If you need accommodation for any part of the application process because of a medical condition or disability, please email ******************************. Information about how Cambia Health Solutions collects, uses, and discloses information is available in our Privacy Policy.
    $135k-145k yearly Auto-Apply 16d ago
  • Senior Digital Designer

    Humana 4.8company rating

    Salt Lake City, UT job

    **Become a part of our caring community and help us put health first** The Senior Digital Designer responsible for creating, executing, developing, and maintaining digital design elements across multiple platforms. The Senior Digital Designer work assignments involve moderately complex to complex issues where the analysis of situations or data requires an in-depth evaluation of variable factors. The Senior Digital Designer collaborate closely with cross-functional teams to conceptualize, design, and produce digital content, graphics, animations, and user interfaces that align with organizational goals and enhance the user experience. Utilize common frameworks to build and develop interactive and responsive digital solutions that ensure compatibility, efficiency, and maximum value for the end-user. Support various business objectives, including product development, advertising, marketing, media, and communications. Begins to influence department's strategy. Makes decisions on moderately complex to complex issues regarding technical approach for project components, and work is performed without direction. Exercises considerable latitude in determining objectives and approaches to assignments. **Use your skills to make an impact** Typically requires Bachelor's degree or equivalent and 5+ years of technical experience Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required. **Scheduled Weekly Hours** 40 **Pay Range** The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc. $94,900 - $130,500 per year This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance. **Description of Benefits** Humana, Inc. and its affiliated subsidiaries (collectively, "Humana") offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities. Application Deadline: 02-22-2026 **About us** Humana Inc. (NYSE: HUM) is committed to putting health first - for our teammates, our customers and our company. Through our Humana insurance services and CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health - delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare, Medicaid, families, individuals, military service personnel, and communities at large. **Equal Opportunity Employer** It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment. Humana complies with all applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, sex, sexual orientation, gender identity or religion. We also provide free language interpreter services. See our ***************************************************************************
    $94.9k-130.5k yearly 8d ago
  • Associate Actuary, SPA-Rx

    Humana 4.8company rating

    Salt Lake City, UT job

    **Become a part of our caring community and help us put health first** The Associate Actuary, Analytics/Forecasting analyzes and forecasts financial, economic, and other data to provide accurate and timely information for strategic and operational decisions. Establishes metrics, provides data analyses, and works directly to support business intelligence. Evaluates industry, economic, financial, and market trends to forecast the organization's short, medium and long-term financial and competitive position. The Associate Actuary, Analytics/Forecasting work assignments involve moderately complex to complex issues where the analysis of situations or data requires an in-depth evaluation of variable factors. _This a remote nationwide position_ The Associate Actuary, Analytics/Forecasting ensures data integrity by developing and executing necessary processes and controls around the flow of data. Collaborates with stakeholders to understand business needs/issues, troubleshoots problems, conducts root cause analysis, and develops cost effective resolutions for data anomalies. Begins to influence department's strategy. Makes decisions on moderately complex to complex issues regarding technical approach for project components, and work is performed without direction. Exercises considerable latitude in determining objectives and approaches to assignments. **Use your skills to make an impact** **Required Qualifications** + Bachelor's Degree + Associate of Society of Actuaries (ASA) designation + MAAA + Strong communication skills + Must be passionate about contributing to an organization focused on continuously improving consumer experiences **Preferred Qualifications** + Prior Part D experience + Strong SAS skills + Prior Databricks experience **Our Hiring Process** As part of our hiring process for this opportunity, we may contact you via text message and email to gather more information using a software platform called Modern Hire. Modern Hire Text, Scheduling and Video technologies allow you to interact with us at the time and location most convenient for you. If you are selected to move forward from your application prescreen, you may receive correspondence inviting you to participate in a pre-recorded Voice, Text Messaging and/or Video interview. Your recorded interview will be reviewed and you will subsequently be informed if you will be moving forward to next round of interviews If you have additional questions regarding this role posting and are an Internal Candidate, please send them to the Ask A Recruiter persona by visiting go/Buzz and searching Ask A Recruiter! Please be sure to provide the requisition number so we may be able to research your request quicker. **Alert:** Humana values personal identity protection. Please be aware that applicants selected for leader review may be asked to provide a social security number, if it is not already on file. When required, an email will be sent from ******************** with instructions to add the information into the application at Humana's secure website. **_Humana is more than an equal opportunity employer, Humana's dedication to promoting diversity, multiculturalism, and inclusion is at the heart of what we do in all of our Humana roles. Diversity is more than a commitment to us, it is the foundation of what we do. We are fully focused on diversity of race, gender, sexual orientation, religion, ethnicity, national origin and all of the other fascinating characteristics that make us each uniquely wonderful._** \#LI-Remote Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required. **Scheduled Weekly Hours** 40 **Pay Range** The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc. $106,900 - $147,000 per year This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance. **Description of Benefits** Humana, Inc. and its affiliated subsidiaries (collectively, "Humana") offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities. Application Deadline: 01-29-2026 **About us** Humana Inc. (NYSE: HUM) is committed to putting health first - for our teammates, our customers and our company. Through our Humana insurance services and CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health - delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare, Medicaid, families, individuals, military service personnel, and communities at large. **Equal Opportunity Employer** It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment. Humana complies with all applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, sex, sexual orientation, gender identity or religion. We also provide free language interpreter services. See our ***************************************************************************
    $106.9k-147k yearly Easy Apply 30d ago
  • Senior IT Product Manager - Information Marketplace & Data Governance Platform

    Humana 4.8company rating

    Salt Lake City, UT job

    **Become a part of our caring community and help us put health first** The Senior IT Product Manager - Information Marketplace & Data Governance is responsible for the strategic vision, roadmap, and execution of the Information Marketplace and its ecosystem of integrated enterprise capabilities. This role owns the end-to-end product lifecycle for the Information Marketplace as well as integrations with its supporting capabilities, data discovery, data quality and observability, metadata management, data cataloging, semantic enablement, and governed data usage processes such as the Protected Information Review Council (PIRC). The Information Marketplace serves as the front door and starting off point for finding and understanding Humana's data. It serves a large role in day-to-day data usage and management processes and that role will continue to expand and evolve. The Senior IT Product Manager partners closely with data governance leadership, architecture, engineering, security, compliance, and business stakeholders to ensure these capabilities operate as a cohesive, scalable product that enables trusted data use, risk reduction, and business value realization. They will create, prioritize and manage product backlogs with a focus on iteration and scalability. They will directly influence department strategy and make decisions on moderately complex to complex issues regarding technical and non-technical approaches for project components. Work will be performed without direction and considerable latitude will need to be exercised in determining objectives and approaches. Detailed Responsibilities **Product Strategy & Vision** + Define and own the long-term product vision and roadmap for the Information Marketplace and its integration to supporting capabilities and processes. + Translate enterprise data governance, compliance, and analytics strategies into actionable product capabilities and prioritized initiatives. + Act as the product authority for how data discovery, quality, observability, metadata management, and semantic layers work together as a unified experience. **Information Marketplace Ownership** + Own the Information Marketplace as a core enterprise product, including user experience, adoption, scalability, and extensibility. + Ensure the Marketplace enables intuitive discovery of curated and un-curated data assets. + Drive continuous improvement of Marketplace capabilities based on usage analytics, stakeholder feedback, and emerging governance trends. **Platform Integrations & Ecosystem Management** + Lead integration strategy and execution across platforms supporting: + Data quality and observability + Data cataloging and metadata management + Data lineage and impact analysis + Semantic layers and business term enablement + Workflow and approval processes (e.g., PIRC) + Partner with architecture and engineering teams to ensure integrations are scalable, secure, resilient, and aligned with enterprise standards. + Manage dependencies across internal platforms, vendor tools, and custom-built solutions. **Stakeholder Engagement & Leadership** + Serve as the primary product interface between data governance leadership and stakeholders. + Facilitate prioritization decisions. + Communicate product strategy, roadmap progress, and outcomes to executive and senior leadership audiences. **Delivery & Execution** + Own and manage the product backlog, ensuring clear articulation of epics, features, and acceptance criteria. + Partner with agile delivery teams to ensure timely, high-quality execution of product initiatives. + Define and track success metrics related to adoption, data trust, operational efficiency, and risk reduction. **Use your skills to make an impact** **Required Qualifications** + 8+ years of experience in product management, technology product ownership, or platform leadership roles. + Proven experience managing complex, enterprise-scale platforms with multiple integrations and stakeholders. + Demonstrated success owning products across the full lifecycle, from strategy and vision through delivery and adoption. + Ability to work effectively with architects and engineers on integration patterns, APIs, metadata flows, and platform interoperability. + Experience operating in hybrid or multi-platform environments, including vendor tools and custom-built solutions. + Exceptional stakeholder management skills, with the ability to influence without direct authority. **Preferred Qualifications** + Strong understanding of data governance concepts, including metadata management, data quality, data lineage, and data stewardship. + Experience with data discovery, data cataloging, or information marketplace-style platforms. + Familiarity with compliance-driven data usage processes (e.g., privacy reviews, data access approvals, risk assessments). + Strong understanding of how semantic layers, business glossaries, and metadata drive analytics and AI enablement. + Strong executive communication skills, including the ability to translate complex technical concepts into business outcomes. + Experience supporting regulated industries (e.g., healthcare, financial services, insurance). + Exposure to data observability platforms, data quality automation, or AI-enabled governance capabilities. + Experience operationalizing governance processes through workflow tools or custom platforms. Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required. **Scheduled Weekly Hours** 40 **Pay Range** The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc. $104,000 - $143,000 per year This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance. **Description of Benefits** Humana, Inc. and its affiliated subsidiaries (collectively, "Humana") offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities. Application Deadline: 03-26-2026 **About us** Humana Inc. (NYSE: HUM) is committed to putting health first - for our teammates, our customers and our company. Through our Humana insurance services and CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health - delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare, Medicaid, families, individuals, military service personnel, and communities at large. **Equal Opportunity Employer** It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment. Humana complies with all applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, sex, sexual orientation, gender identity or religion. We also provide free language interpreter services. See our ***************************************************************************
    $104k-143k yearly 8d ago
  • Clinical Programs Pharmacy Technician

    Humana 4.8company rating

    Salt Lake City, UT job

    **Become a part of our caring community and help us put health first** As a Rx Clinical Programs Pharmacy Technician Representative 2 you will support Pharmacists and patients by executing programs developed to improve overall health outcomes with a focus on prescription drugs, and medication therapy and helps drive the strategy on comprehensive medication reviews. As a Rx Clinical Programs Pharmacy Technician Representative 2 you will perform varied activities and moderately complex administrative/operational/customer support assignments. Performs computations. Typically works on semi-routine assignments. In this role as a Rx Clinical Programs Pharmacy Technician Representative 2 you will assist in driving prescription drug optimization in cases where patients are taking multiple medications. Through effective communication, helps drive health awareness with patients through Rx Education and targeted quarterly campaigns. Assists Pharmacists by placing and retrieving calls to confirm patients are taking drugs and provides counseling. Decisions are typically focus on interpretation of area/department policy and methods for completing assignments. Works within defined parameters to identify work expectations and quality standards, but has some latitude over prioritization/timing, and works under minimal direction. Follows standard policies/practices that allow for some opportunity for interpretation/deviation and/or independent discretion. In this role, you will: + Make outbound and take inbound calls + Communicate with Humana members + Collect medication history information + Prepare members for a comprehensive medication review **Use your skills to make an impact** Additional Job Description ****PLEASE MAKE SURE YOU ATTACH YOUR RESUME TO YOUR APPLICATION (PDF OR WORD FORMAT) **** **_*Earn a $1,500 hiring sign on bonus!_** * (50% payable at hire and 50% payable at 180 days; you must be employed until that date to be eligible to receive the payment!) + Applicable to external candidates only **Required Qualifications** + **Resident State Pharmacy Technician License** **OR** **National Pharmacy Technician Certification** + High School Diploma or equivalent + Excellent communication skills both written and verbal + Applied knowledge of insurance processing, customer service or call center processes and practices + High speed hardwired internet and phone, minimum speed 20Mbps + Must have a designated work area with a door that locks **Schedule:** Must have the flexibility to work any hours between 8:00am-7:00pm EST and holidays/weekends and overtime as needed. + **You must be on time, dressed appropriately, with your camera ON during 2+ weeks of training and for other meetings required by leadership** . Attendance is vital for success, time off during your 180-day appraisal period is not permitted. Exception: Should a Humana-observed holiday occur during training or within the 180-day appraisal period, you will have the holiday off (paid). **Preferred Qualifications** + Associate's degree or equivalent work experience + Experience in mail order and/or retail pharmacy setting + Ability to speak both English and Spanish fluently + Previous call center experience in a pharmacy setting + Strong communication and telephonic skills + Ability to solve problems and encourage others in collaborative problem solving + Self-directed, but also able to work well in a group + A positive, proactive attitude, energetic, highly motivated and a self-starter + Work ethic that is focused, accurate and highly productive **Referral Bonus Information** Associates may receive a bonus for the referral of external candidates to this requisition, provided that all other eligibility requirements are met. Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required. **Scheduled Weekly Hours** 40 **Pay Range** The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc. $40,000 - $52,300 per year **Description of Benefits** Humana, Inc. and its affiliated subsidiaries (collectively, "Humana") offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities. **About us** Humana Inc. (NYSE: HUM) is committed to putting health first - for our teammates, our customers and our company. Through our Humana insurance services and CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health - delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare, Medicaid, families, individuals, military service personnel, and communities at large. **Equal Opportunity Employer** It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment. Humana complies with all applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, sex, sexual orientation, gender identity or religion. We also provide free language interpreter services. See our ***************************************************************************
    $40k-52.3k yearly 2d ago
  • Medical Assistant - Primary Care

    Unitedhealth Group Inc. 4.6company rating

    Taylorsville, UT job

    $4,000 Sign-on Bonus for External Candidates For those who want to invent the future of health care, here's your opportunity. We're going beyond basic care to health programs integrated across the entire continuum of care. Join us to start Caring. Connecting. Growing together. The Medical Assistant performs a variety of back office activities to assist providers in conducting quality clinics, including administering injections, diagnostic testing, phlebotomy, quality surveys and various other procedures. Delivers exceptional customer service and maintains established quality control standards. * Sign On Bonus - $4000 after 30 days of employment * Overtime eligible at time and half * Annual performance bonus potential * Paid Time Off (PTO) which you start to accrue with your first pay period plus 8 Paid Holidays * Career development and training for other roles you may be interested * Medical Plan options, Dental, Vision, Life& AD&D Insurance within 30 days of hire * 401(k) Savings Plan, Employee Stock Purchase Plan * Education Reimbursement * Employee Discounts Primary Responsibilities: * Support up to 1 MD, 1 DO and 1 APC at Primary Care Practice * Lead back-office operations to include screening / rooming patients, documentation in EMRs, quality assurance, and training of new personnel * Assist in the care of the patient by following through on Provider orders for treatments * Taking the patients vital signs and conducting blood draws as certified * Have certification or are working towards their certification as a Medical Assistant * Assist providers with patient care * Complete screenings and tests on patients * Document in patient's EMR * Assist with front desk responsibilities * Collect / process lab specimens You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in. Required Qualifications: * High school graduate or GED * Completion of a Medical Assistant program, or relevant experience * Current CPR and/or BLS certification or ability to obtain certification within 30 days of hire * Access to reliable transportation Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The hourly pay for this role will range from $16.00 to $27.69 per hour based on full-time employment. We comply with all minimum wage laws as applicable. At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission. OptumCare is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations. OptumCare is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.
    $16-27.7 hourly 15d ago
  • Part Time Licensed Therapist - LCSW, LCMHC, LMFT - Provo

    Unitedhealth Group 4.6company rating

    Provo, UT job

    Sundance Behavioral Health, part of the Optum family of businesses, is seeking a part-time Licensed Clinical Therapist to join our team in Provo, UT. As a member of the Optum Behavioral Care team, you'll be an integral part of our vision to make healthcare better for everyone. As a Licensed Clinical Therapist, you will treat a wide variety of mental health conditions that reflect the needs of our diverse patient population. We offer a variety of solutions that meet the unique needs of our workforce and the patients they serve. From clinical operations such as credentialing to business operations such as contracting, we provide organizational support that allows our providers to focus on what matters - providing care. This part-time position is based on site at our Provo, UT office having in-person sessions. Flexibility for telehealth sessions may be considered. You will have the flexibility to create your own schedule provided client needs are met. We are committed to your well-being and growth, offering a comprehensive package of perks and benefits with varying eligibility based on role, including: + Competitive hourly pay & uncapped productivity incentives + Flexible work models & paid time off when you need it + Health and well-being benefits like health insurance, 401k matching, and other family support and wellness resources + Professional development with continuing education (CE) reimbursement and dedicated learning time to advance your career **Primary Responsibilities:** + Screen and assess patients for common mental health and substance abuse disorders + Provide treatment for mental health conditions using various approaches including cognitive behavioral therapy, dialectical behavioral therapy, and other evidence-based methods + Systematically track treatment response and monitor patients for changes in clinical symptoms and treatment side effects or complications + Maintain accurate and up-to-date electronic medical records and clinical documentation, ensuring compliance with all regulatory requirements + Participate in our patient growth strategy by providing a profile for online directories and other marketing efforts You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in. **Required Qualifications:** + Master's degree in psychology, social work, or a related counseling field + Must have a clear, active and unrestricted license that allows you to practice without supervision (LCSW, LMFT, or LCMHC) in Utah **Preferred Qualifications:** + 2+ years of professional experience post master's degree providing behavioral health services + Experience providing direct psychotherapy services to individuals and families + Experience working with computers for professional communication and medical documentation - Excel, Outlook, Athena RMS (or other EHRs) + Ability to work both independently and collaboratively with equal effectiveness Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The hourly pay for this role will range from $28.94 to $51.63 per hour based on full-time employment. We comply with all minimum wage laws as applicable. _At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission._ _UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations._ _UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment._
    $28.9-51.6 hourly 8d ago
  • Supervisor, Provider Data Management

    Centene Management Company 4.5company rating

    Salt Lake City, UT job

    You could be the one who changes everything for our 28 million members. Centene is transforming the health of our communities, one person at a time. As a diversified, national organization, you'll have access to competitive benefits including a fresh perspective on workplace flexibility. ***NOTE: For this role we are seeking candidates who live in Honolulu, Hawaii*** Position Purpose: Manage the daily operations of all provider data management functions. Direct provider data management related activities based on plan and contract specifications and standard business rules - includes data analysis and entry, review of data via internet sites and other systems, usage of multiple systems and applications to validate data is complete and accurate, and investigation and resolution of data issues. Manage the end-to-end provider data entry and maintenance to ensure accurate and timely setup for claims payment, member assignment and directory display Investigate and resolve complex provider data management issues Identify trends and recommend improvements to mitigate potential issues Lead task assignment for team's workflow and distribution Monitor team performance to ensure established and provider data quality benchmarks are met Facilitate meetings with Health Plan representatives Train and mentor Provider Data Management Analyst I, II, and Team Leads Performs other duties as assigned Complies with all policies and standards Education/Experience: Bachelor's degree in related field or equivalent experience. 3+ years of combined management and provider data management, data analysis, and customer service experience preferably with healthcare operations (i.e. claims processing, billing, provider relations or contracting) experience in a managed care, insurance, or medical office environment. Experience performing and leading teams.Pay Range: $56,200.00 - $101,000.00 per year Centene offers a comprehensive benefits package including: competitive pay, health insurance, 401K and stock purchase plans, tuition reimbursement, paid time off plus holidays, and a flexible approach to work with remote, hybrid, field or office work schedules. Actual pay will be adjusted based on an individual's skills, experience, education, and other job-related factors permitted by law, including full-time or part-time status. Total compensation may also include additional forms of incentives. Benefits may be subject to program eligibility. Centene is an equal opportunity employer that is committed to diversity, and values the ways in which we are different. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other characteristic protected by applicable law. Qualified applicants with arrest or conviction records will be considered in accordance with the LA County Ordinance and the California Fair Chance Act
    $56.2k-101k yearly Auto-Apply 13d ago
  • Semantic Architect

    Cambia Health 3.9company rating

    Cambia Health job in Salt Lake City, UT

    SEMANTIC ARCHITECT (HEALTHCARE) Telecommute (Possible 2026 Return to office) - within Oregon, Washington, Idaho or Utah Build a career with purpose. Join our Cause to create a person-focused and economically sustainable health care system. Who We Are Looking For: Every day, Cambia's Data & Analytics Engineering Team is living our mission to make health care easier and lives better. We're seeking a seasoned Data and Analytics Engineer with extensive semantic data architecture experience to design and implement, expand, and enhance our existing semantic layer within our Snowflake data platform to support AI-driven semantic intelligence and BI for our health insurance payer organization. The role will focus on creating a robust, scalable semantic framework that enhances data discoverability, interoperability, and usability for AI tools, enabling advanced analytics, predictive modeling, and actionable insights. - all in service of making our members' health journeys easier. If you're a motivated and experienced Semantic Professional looking to make a difference in the healthcare industry, apply for this exciting opportunity today! What You Bring to Cambia: Qualifications and Certifications: * Bachelor's degree in computer science, Mathematics, Business Administration, Engineering, or a related field * 8 years relevant experience in a multi-platform environment, including, but not limited to application development or database development * At least 2 years working with Snowflake or similar cloud data platforms * Equivalent combination of education and experience What You Will Do at Cambia (Not limited to): * Enterprise Semantic Layer: Design, develop, extend, and maintain semantic data models on Snowflake to standardize data definitions, relationships, and ontologies for healthcare data (e.g., claims, member data, provider data). * Data Integration: Collaborate with data engineers to integrate structured and unstructured data from internal (e.g., claims systems, EHRs) and external sources into the semantic layer. When necessary, develop and optimize ETL/ELT pipelines to populate the semantic layer, integrating data from diverse sources (e.g., claims, member data, third-party feeds) using Snowflake's capabilities. * Analytics and AI Enablement: Ensure the semantic layer supports analytics, BI, and AI use cases, such as predictive analytics for risk stratification, fraud detection, and member engagement. * Governance and Standards: Work closely with our Data Governance organization to develop governance policies, metadata standards, and ontologies to ensure consistency, compliance, and interoperability. * Stakeholder Collaboration: Work with business analysts, data modelers, data engineers, and business users to translate business requirements into semantic data models that support self-service analytics and enable AI analysis and agents. * Performance Optimization: Optimize semantic models for query performance and scalability on Snowflake, taking advantage of Snowflake's current and future features. * Documentation and Training: Document semantic models and provide training to end-users and technical teams on leveraging the semantic layer. Skills and Attributes (Not limited to): * Preferred: Experience with FHIR, HL7, or other healthcare data standards; familiarity with tools like Collibra or Informatica for metadata management. * Expertise in semantic technologies, including Snowflake semantic views, MicroStrategy, AtScale, or Business Objects universes, and familiarity with healthcare ontologies (e.g., SNOMED, LOINC, ICD-10). * Strong understanding of analytics workflows and their data requirements. * Experience with data governance, metadata management, and compliance in healthcare. * Proficiency in dimensional data modeling. * Proficiency in SQL and experience with Snowflake-specific features. * Experience using code repositories such as GitLab or GitHub and CI/CD-based deployment. * Excellent communication skills to bridge technical and business teams. * Preferred: Experience with FHIR, HL7, or other healthcare data standards; familiarity with tools like Collibra or Informatica for metadata management. The expected hiring range for The Semantic Architect II is $135k-$145k and Semantic Architect III is $160k-$175k depending on skills, experience, education, and training; relevant licensure / certifications; performance history; and work location. The bonus target for the Architect II is 15% and Architect III is 25%. The current full salary range for the Architect II position is $113k Low/ $142k MRP / $185k High. The Architect III salary range is $138k Low/ $173k MRP / $225k About Cambia Working at Cambia means being part of a purpose-driven, award-winning culture built on trust and innovation anchored in our 100+ year history. Our caring and supportive colleagues are some of the best and brightest in the industry, innovating together toward sustainable, person-focused health care. Whether we're helping members, lending a hand to a colleague or volunteering in our communities, our compassion, empathy and team spirit always shine through. Why Join the Cambia Team? At Cambia, you can: * Work alongside diverse teams building cutting-edge solutions to transform health care. * Earn a competitive salary and enjoy generous benefits while doing work that changes lives. * Grow your career with a company committed to helping you succeed. * Give back to your community by participating in Cambia-supported outreach programs. * Connect with colleagues who share similar interests and backgrounds through our employee resource groups. We believe a career at Cambia is more than just a paycheck - and your compensation should be too. Our compensation package includes competitive base pay as well as a market-leading 401(k) with a significant company match, bonus opportunities and more. In exchange for helping members live healthy lives, we offer benefits that empower you to do the same. Just a few highlights include: * Medical, dental and vision coverage for employees and their eligible family members, including mental health benefits. * Annual employer contribution to a health savings account. * Generous paid time off varying by role and tenure in addition to 10 company-paid holidays. * Market-leading retirement plan including a company match on employee 401(k) contributions, with a potential discretionary contribution based on company performance (no vesting period). * Up to 12 weeks of paid parental time off (eligibility requires 12 months of continuous service with Cambia immediately preceding leave). * Award-winning wellness programs that reward you for participation. * Employee Assistance Fund for those in need. * Commute and parking benefits. Learn more about our benefits. We are happy to offer work from home options for most of our roles. To take advantage of this flexible option, we require employees to have a wired internet connection that is not satellite or cellular and internet service with a minimum upload speed of 5Mb and a minimum download speed of 10 Mb. We are an Equal Opportunity employer dedicated to a drug and tobacco-free workplace. All qualified applicants will receive consideration for employment without regard to race, color, national origin, religion, age, sex, sexual orientation, gender identity, disability, protected veteran status or any other status protected by law. A background check is required. If you need accommodation for any part of the application process because of a medical condition or disability, please email ******************************. Information about how Cambia Health Solutions collects, uses, and discloses information is available in our Privacy Policy.
    $160k-175k yearly Auto-Apply 60d+ ago
  • Informaticist

    Humana 4.8company rating

    Salt Lake City, UT job

    **Become a part of our caring community and help us put health first** The Provider Analytics organization's vision is to improve member healthcare through innovative analytics and actionable insights, which empower members, and providers to drive higher quality, lower cost of care, and improved health outcomes. Provider Analytics develops and applies actionable analytics and insights, which are integral to business needs, to drive informed provider network strategy and is looking for an Informaticist 2 to join their team. The Informaticist 2: + Designs and constructs models to estimate impact of contractual changes tied to ancillary and industry leading innovative care delivery models + Collates, models, interprets and analyzes data in order to identify, explain, and influence variances and trends + Explains variances and trends and enhances modeling techniques + Utilizes multiple data sources such as SQL, Power BI, Excel, etc., to create advanced analytics to facilitate contracting initiatives + Uses a consultative approach to collaborate effectively with the markets, and other customers, building productive cross-functional relationships + Extracts historical data, performs data mining, develops insights to drive provider contracting strategy and reimbursement terms for National Ancillary Contracting + Develops tools and automates processes to model financial implications of ancillary contracted rate changes, including changes in capitated arrangements In addition to being a great place to work, Humana also offers industry leading benefits for all employees, starting your FIRST day of employment. Benefits include: + Medical Benefits + Dental Benefits + Vision Benefits + Health Savings Accounts + Flex Spending Accounts + Life Insurance + 401(k) + PTO including 9 paid holidays, one personal holiday, one day of volunteer time off, 23 days of annual PTO, parental leave, caregiving leave, and weekly well-being time + And more **Use your skills to make an impact** **Required Qualifications** + 3+ years of demonstrated healthcare analytical experience + 1+ years SQL experience + 1+ years' experience in data visualization (ie. Power BI, Tableau, etc.) + Experience in compiling, modeling, interpreting and analyzing data in order to identify, explain, influence variances and trends + Experience in managing data to support and influence decisions on day-to-day operations, strategic planning and specific business performance issues + Possess a working knowledge and understand department, segment and organizational strategy **Preferred Qualifications** + Bachelor's Degree in analytics or related field + Advanced Degree + Understanding of healthcare membership, claims, and other data sources used to evaluate cost and other key financial and quality metrics **Additional Information** Work at Home/Remote Requirements **Work-At-Home Requirements** + To ensure Home or Hybrid Home/Office associates' ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office associates must meet the following criteria: + At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is recommended to support Humana applications, per associate. + Wireless, Wired Cable or DSL connection is suggested. + Satellite, cellular and microwave connection can be used only if they provide an optimal connection for associates. The use of these methods must be approved by leadership. (See Wireless, Wired Cable or DSL Connection in Exceptions, Section 7.0 in this policy.) + Humana will not pay for or reimburse Home or Hybrid Home/Office associates for any portion of the cost of their self-provided internet service, with the exception of associates who live or work from Home in the state of California, Illinois, Montana, or South Dakota. Associates who live and work from Home in the state of California, Illinois, Montana, or South Dakota will be provided a bi-weekly payment for their internet expense. + Humana will provide Home or Hybrid Home/Office associates with telephone equipment appropriate to meet the business requirements for their position/job. + Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information **Our Hiring Process** As part of our hiring process, we will be using an exciting interviewing technology provided by HireVue, a third-party vendor. This technology provides our team of recruiters and hiring managers an enhanced method for decision-making. If you are selected to move forward from your application prescreen, you will receive correspondence inviting you to participate in a pre-recorded Voice, Text Messaging, and/or Video Interview. If participating in a pre-recorded interview, you will respond to a set of interview questions via your phone or computer. You should anticipate this interview to take approximately 10-15 minutes. Your recorded interview(s) via text and/or pre-recorded voice will be reviewed and you will subsequently be informed if you will be moving forward to next round of interviews. If you have additional questions regarding this role posting and are an Internal Candidate, please send them to the Ask A Recruiter persona by visiting go/Buzz and searching Ask A Recruiter! Please be sure to provide the requisition number so we may be able to research your request quicker. \#LI-LM1 Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required. **Scheduled Weekly Hours** 40 **Pay Range** The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc. $73,400 - $100,100 per year This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance. **Description of Benefits** Humana, Inc. and its affiliated subsidiaries (collectively, "Humana") offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities. Application Deadline: 01-21-2026 **About us** Humana Inc. (NYSE: HUM) is committed to putting health first - for our teammates, our customers and our company. Through our Humana insurance services and CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health - delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare, Medicaid, families, individuals, military service personnel, and communities at large. **Equal Opportunity Employer** It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment. Humana complies with all applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, sex, sexual orientation, gender identity or religion. We also provide free language interpreter services. See our ***************************************************************************
    $73.4k-100.1k yearly 6d ago
  • Pharmacy Care Coordinator

    Unitedhealth Group 4.6company rating

    Salt Lake City, UT job

    **Opportunities with Genoa Healthcare.** A career with Genoa Healthcare means you're part of a collaborative effort to serve behavioral health and addiction treatment communities. We do more than just provide medicine: we change lives for the better. People with serious mental or chronic illness - and those who care for them - have moving stories, and at Genoa we become their voice, their partner. Working as part of a coordinated care team, we partner with community-based providers and others to ensure that people with complex health conditions get the right medications and are able to follow their treatment plans. Our personalized services - in-clinic pharmacies, medication management and more - are leading the way to a new level of care. Genoa is a pharmacy care services company that is part of Optum and UnitedHealth Group's family of businesses. We are part of a leading information and technology-enabled health services business dedicated to making the health system work better for everyone. Join us to start **Caring. Connecting. Growing together.** The **Patient Care Coordinator** position at Genoa is an essential role that impacts the lives of an underserved population that needs a voice. This position is a liaison between a partner clinic and a Genoa mental health specialty pharmacy. Primary responsibilities include building strong relationships with the clinic partners and communicating with consumers to assist them with their medication plan, insurance and the full services of the Genoa pharmacy. A key function will be promoting Genoa services to obtain new consumers and increasing the number of consumers Genoa serves. **Hours:** Monday-Friday 8:30am to 5:30pm MST **Location:** 4 days at 3802 S 700 E, Salt Lake City, UT, 84106 and 1 day at 154 East Myrtle Ave, Ste 101, Murray, UT, 84107; manager will let you know which days will be at which site **Primary Responsibilities:** + Communicates with all consumers of the mental health center regarding the medication services Genoa provides + Recruits and enrolls consumers utilizing enrollment forms and copy the consumer's insurance card + Facilitates the collection of prescriptions to be faxed to the pharmacy for dispensing + Ensures all consumer insurance information is up to date in the Pharmacy system and is properly charged for the medications dispensed + Assists consumers in contacting the pharmacist regarding all their medication questions and ensure a prompt response to their questions + Assists clinic staff and pharmacy with prior authorizations and Patient Assistance programs as needed + Monitors compliance by contacting the consumer at least monthly to ensure compliance and determine refill needs as applicable + Prescription refill management by utilizing the no refill report and contacting the appropriate prescriber to ensure timely refills are completed and dispensed to the consumer + Medication delivery when needed and appropriate. {Only applicable in states that are allowed.} + Checks for expiration dates (both on consumer's medications as well as house account products/standing order meds) + Ensures that medications are stored properly (refrigerated drugs are kept in the refrigerator, pen-tips are not stored on insulin pens, etc.) + Checks for discrepancies (dose changes, discontinued medications, etc.) **What are the reasons to consider working for UnitedHealth Group? Put it all together - competitive base pay, a full and comprehensive benefit program, performance rewards, and a management team who demonstrates their commitment to your success. Some of our offerings include:** + Paid Time Off which you start to accrue with your first pay period plus 8 Paid Holidays + Medical Plan options along with participation in a Health Spending Account or a Health Saving account + Dental, Vision, Life& AD&D Insurance along with Short-term disability and Long-Term Disability coverage + 401(k) Savings Plan, Employee Stock Purchase Plan + Education Reimbursement + Employee Discounts + Employee Assistance Program + Employee Referral Bonus Program + Voluntary Benefits (pet insurance, legal insurance, LTC Insurance, etc.) + More information can be downloaded at: ************************* You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in. **Required Qualifications:** + Active and unrestricted Pharmacy Technician license in the state of Utah + Access to reliable transportation & valid US driver's license **Preferred Qualification:** + National Pharmacy Technician Certification Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The hourly pay for this role will range from $17.74 to $31.63 per hour based on full-time employment. We comply with all minimum wage laws as applicable. _At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location, and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups, and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission._ _UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations._ _UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment._ \#RPO #RED
    $17.7-31.6 hourly 60d+ ago

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